NPI | 1558577239 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.007292) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34001394A) |
Enumeration Date | 2007-05-16 |
Last Update Date | 2015-11-04 |